Communication After Emergent Surgery by English Proficiency: An Exploratory Qualitative Study

Area of Science:

• Geriatric Surgery
• Health Communication
• Qualitative Research

Background:

• Older adults with Limited English Proficiency (LEP) are a significant patient population in trauma and emergency general surgery (EGS).
• Communication barriers are prevalent for LEP individuals, potentially worsened by acute surgical admissions.
• This vulnerable demographic and their specific communication needs in surgical settings are understudied.

Purpose of the Study:

• To explore communication experiences of older adults with Limited English Proficiency (LEP) and English Proficiency (EP) hospitalized for trauma or EGS.
• To identify factors influencing patient understanding, autonomy, and feedback in surgical care settings.

Main Methods:

• Exploratory qualitative study involving purposive sampling of trauma/EGS inpatients aged 65+ with mild/no cognitive impairment.
• Semi-structured interviews with patients and families, utilizing professional interpreters for LEP patients.
• Thematic analysis of interview transcripts using modified grounded theory; examination of interpreter errors.

Main Results:

• Three key themes emerged: Lack of Information, Loss of Autonomy, and Feedback/Advocacy.
• Both LEP and EP patients reported limited knowledge of their care and reliance on providers.
• EP patients and LEP family members offered critiques, while LEP patients were hesitant to provide feedback; professional interpreters made errors.

Conclusions:

• Language proficiency and communication styles contribute to significant communication barriers for LEP patients in trauma/EGS.
• Professional interpreter errors likely compound these difficulties.
• Findings highlight the need for further research into communication's impact on patient outcomes for diverse surgical populations.